Anti-spasmodic effects of Zizyphus lotus (L.) Desf. extracts on isolated rat duodenum

Aim of the study

The present study deals with the anti-spasmodic activity of the aqueous and the methanolic extracts of the leaves and the root barks of Zizyphus lotus (L.) Desf. on male rats.

Materials and methods

This activity was assessed on contractions of isolated rat duodenum, induced by acetylcholine, KCl, and BaCl₂ and compared with the effect of atropine and papaverine.

Results

Both extracts of leaves and root barks caused significant relaxation of spontaneous contractions and produced a concentration-dependent inhibition (P < 0.01–0.001) of contraction induced by spasmogenic agents.

Conclusion

These results indicate that Zizyphus lotus extracts contain anti-spasmodic constituents mediating their effect through cholinergic receptors and blockade Ca²⁺ influx. This could explain the traditional use of Zizyphus lotus in the treatment of the intestinal diseases.     

Incarcerated primary anterior liver hernia: A case report

The anterior liver hernia is a very rare entity that mainly occurs within an incisional hernia. Primary anterior liver hernia, in the absence of a previous abdominal incision, is extremely rare. The diagnosis is suspected in patients with epigastric bulging. The confirmation requires imaging studies such as computed tomography scan (CT scan). We report the case of an incarcerated primary ventral liver hernia, in an 83-year-old man who presented with a sudden epigastric swelling. A contrast-enhanced CT scan confirmed the diagnosis of incarcerated epigastric hernia with liver and epiploic content. Risk factors were thought to be the increased intra-abdominal pressure related to benign prostate hyperplasia, as well as the old age of the patient. The surgical conservative management was successful.     

SLEEVEPASS: A randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results

Background

The long-term efficacy of laparoscopic Roux-en-Y gastric bypass (RYGB) in the treatment of morbid obesity has been demonstrated. Laparoscopic sleeve gastrectomy (SG) as a single procedure has shown promising short-term results, but the long-term efficacy of SG has not yet been demonstrated. The aim of this study was to determine the preliminary 30-day morbidity and mortality of RYGB and SG in a prospective multicenter randomized setting.

Methods

A total of 240 morbidly obese (BMI?=?35–66?kg/m2) patients evaluated by a multidisciplinary team were randomized to undergo either RYGB or SG. There were 117 patients in the RYGB group and 121 in the SG group; two patients had to be excluded after randomization. Both study groups were comparable regarding age, gender, BMI, and comorbidities.

Results

There was no 30-day mortality. The median operating time was significantly shorter in the SG group (66?min vs. 94?min, p?p?=?0.292). Nine (7.4 %) SG patients and 20 (17.1 %) RYGB patients had minor complications (p?=?0.023). The overall morbidity was 13.2 % after SG and 26.5 % after RYGB (p?=?0.010). There were three (2.5 %) early reoperations after SG and four (3.3 %) after RYGB (p?=?0.719).

Conclusions

At 30-day analysis SG is associated with a shorter operating time and fewer early minor complications compared to RYGB. There were no significant differences in major complications or early reoperations. Long-term follow-up is required to determine the effect on weight loss, resolution of obesity-related comorbidities, and improvement of quality of life.     

(肌)皮瓣修复足部软组织缺损

目的:探讨应用多种(肌)皮瓣修复各种足部软组织缺损的临床效果.方法:根据足部缺损的类型和部位,应用13种(肌)皮瓣修复足部软组织缺损76例.结果:随访半年至18年,1例腓肠神经营养血管逆行岛状皮瓣部分坏死,1例小腿外侧逆行岛状皮瓣皮肤部分坏死,3例皮瓣远端部分表皮坏死,经局部换药后皮瓣成活,其余皮瓣全部成活.3例游离背...     

Myoblast transplantation can repair heart damage

Cell and gene based therapies hold tremendous po- tential to treat cardiovascular diseases. However, signifi- cant obstacles need to be overcome before any realization of potential benefits. There is no doubt that intracoronary or direct injection of either cells or genes into small animal models (mouse, rat, hamster or rabbit) for heart disease pro- duce improvements in cardiac function.1-4 The challenges, however, to treat human heart disease are far greater than in experimental animal syste…     

The perioperative course and anesthetic challenge for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

BackgroundCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) by the closed technique provide a promising therapeutic option for highly selected patients with peritoneal carcinomatosis. CRS with HIPEC is a long and complex procedure with significant blood and fluid loss, hemodynamic, hematological, and metabolic alterations in the perioperative period, with resultant morbidity and mortality. This work was done to evaluate our early experience in anesthesia and early postoperative care for these cases.Patients and methodsThis retrospective study was done on 13 patients for CRS and HIPEC, with intraoperative and early postoperative recording and evaluation of the fluid and blood losses and replacement, changes in hemodynamic, metabolic, and respiratory parameters and any complications happened.ResultsOur data demonstrated high fluid and blood losses during CRS. During HIPEC, raised body temperature, increased central venous pressure and airway pressure, increased arterial partial carbon dioxide tension (PaCO₂), decreased ratio of arterial oxygen partial pressure/fractional inspired oxygen (P_aO₂/F_iO₂), and increased serum lactate were recorded. These were associated with hemodynamic, metabolic, and respiratory acidosis. The patients were continuing resuscitation and correction of any derangements in intensive care unit.ConclusionCRS and HIPEC have become standard treatment for certain peritoneal surface malignancies. This extended surgery is considered a challenge for the anesthetist. It is associated with relevant fluid, blood, and protein losses, together with hemodynamic, respiratory, and metabolic derangements. However, these derangements are short lived and could be controlled by continuous monitoring and rapid intervention.     

Laryngeal findings and acoustic changes in hubble-bubble smokers

The purpose of our investigation was to evaluate the laryngeal findings and acoustic changes in hubble-bubble smokers. A total of 42 subjects with history of hubble-bubble smoking were recruited for this study. A corresponding group with a history of cigarette smoking and controls were matched. All subjects underwent laryngeal video-endostroboscopic evaluation and acoustic analysis. In the hubble-bubble smoking group, 61.9% were males. The average age was 30.02 ± 9.48 years and the average number of years of smoking was 8.09 ± 6.45 years. Three subjects had dysphonia at the time of examination. The incidence of benign lesions of the vocal folds in the hubble-bubble group was 21.5%, with edema being the most common at 16.7% followed by cyst at 4.8%. The incidence of laryngeal findings was significantly higher in the hubble-bubble group compared to controls. In the cigarette-smoking group, the most common finding was vocal fold cyst in 14.8% followed by polyps in 7.4%, and edema, sulcus vocalis and granuloma. These findings were not significantly different from the hubble-bubble group except for the thick mucus, which was significantly higher in the latter. There were no significant changes in any of the acoustic parameters between hubble-bubble smokers and controls except for the VTI and MPT, which were significantly lower in the hubble-bubble group. In comparison with the cigarette-smoking group, hubble-bubble smokers had significantly higher Fundamental frequency and habitual pitch (p value 0.042 and 0.008, respectively). The laryngeal findings in hubble-bubble smokers are comparable to cigarette smokers. These laryngeal findings are not translated acoustically, as all the acoustic parameters are within normal range compared to controls.     

Rifampicin induces the bone form of alkaline phosphatase in humans

Pregnane X receptor (PXR) is a xenobiotic-sensing nuclear receptor that regulates drug metabolism in the liver and intestine. In our clinical trials on healthy volunteers to discover novel metabolic functions of PXR activation, we observed that rifampicin, a well-established ligand for human PXR, 600 mg daily for a week, increased the plasma alkaline phosphatase (ALP) significantly compared with the placebo. Further analysis with lectin affinity electrophoresis revealed that especially the bone form of ALP was elevated. To investigate the mechanism(s) of bone ALP induction, we employed osteoblast lineage differentiated from human primary bone marrow–derived mesenchymal stromal cells. Rifampicin treatment increased ALP activity and mRNA level of bone biomarker genes (ALP, MGP, OPN and OPG). PXR expression was detected in the cells, but the expression was very low compared with the human liver. To further investigate the potential role of PXR in the ALP induction, we treated mice and rats with a rodent PXR ligand pregnenolone 16α-carbonitrile (PCN). However, PCN treatment did not increase plasma ALP activity or bone ALP mRNA expression. In conclusion, rifampicin treatment induces the bone form of ALP in the serum of healthy human volunteers. Further studies are required to establish the mechanism of this novel finding.